Triggers for hypmania/mania

Hi everyone,
We are less than a week into difficult child's new (probable) Early Onset Bi-Polar (EOBP) diagnosis and I have been reading, reading, and reading the whole time. Here's what I'm wondering: What triggers do you see for your BiPolar (BP) child's ascent towards hypomania or mania? Can you identify triggers and what do you do when you see the pattern start?

As I look back over the past month, Bug certainly had a clear episode of mood cycling. I now wonder if I have missed cases in the past because I didn't know what to look for (I assume I have). I think he has spent much of his life in a mixed state, which just makes me want to cry. I hope the new medications help, but I also feel like I need to understand better how to recognize what is happening to him.

On the medication front, he took his first dose of Trileptal with Christmas dinner on Friday. Unfortunately, yesterday he had blood in his stool so the psychiatrist told us to discontinue the medication for a few days and then try again. difficult child has chronic constipation (takes Miralax for it), so both husband and I and the psychiatrist feel like it probably wasn't due to the Trileptal, but we want to make sure.

I have a cold and have had a head/back ache since the visit to the psychiatrist on Wednesday. Perhaps I'm a little stressed. Glad to be seeing both my psychotherapist and physical therapist on Tuesday.

Stress/anxiety, among a lot of other things, can trigger it. Some medications- like allergy or asthmatic medications and steroids seems to trigger it for some. The break from the routine at the holidays along with the over-stimulation and excitement of it all. And sometimes too many sweets or change in diet.

Initial signs can vary- sleeping less or trouble sleeping, excessive talking, being fidgety or hyper. Some get compulsive about things- hyper-focused, if you will, such as in video games, cleaning, etc.

There have been previous threads on this topic in the past- try doing a search and I'm sure you'll find plenty more.

Oh- what to do about it is a tough one and it's the million dollar question. I think people here have tried everything imaginable. Of course you can try to reduce the pressure/stress/anxiety, get the difficult child back on diet and schedule, etc. But, usually if it's really BiPolar (BP) I'm not so sure these things are all that helpful. Try to keep a closer eye on things, prepare for a possible medication change (let psychiatrist know you think this is coming), talk with people at school and have measures in place, and put your rhino skin and warrior armor on! Have a plan in place for home and choose your battles. It is not uncommon for difficult child's to start ddropping signs of things getting out of kelter around the holidays and escalate to major issues around March. The pressures from teachers at school demanding more from students to prepare for school testing probably doesn't help either.

My son is currently in an Residential Treatment Center (RTC) where he is under 24/7 observation, and his BiPolar (BP) diagnosis is still in question despite being on medications and under the care of psychiatrists since the age of 10. The only triggers for hypomania/mania we can identify for certain are SSRIs and extreme anxiety. We reduce anxiety and tweak medications when we see hypomania/mania emerge.

Much like you said, early on, my son was mostly in a mixed state and it was hard to differentiate between mania and depression becoause he was constantly irritatble and agressive and this is a symptom of both. As he's gotton older, we have become a little better at noticing the satrt and heading off full scale mania. This is what we have discovered are triggers for for my difficult child...

Medication becomes less effective due to growth spurt.

Springtime-- Three years in a row we've had March Mania and a need for hospitalization

Stimulant Medications and Steroids (creams and sprays, Cortaid, Vryamyst) like for rashes and allergies.

Caffeine

Over-stimulating environments, lots of people, especially prolonged vacations and visits away from home

here are some signs that my difficult child is heading into a manic episode...

Excessive laughing, we call it his hyenia laugh, loud and long at stuff that really isn't that funny

Rapid talking

Less focused than usual

Looks very much like severe ADHD

Waking in the middle of the night and is not able to go back to sleep

Nightmares

Getting up very early

Increase in fantasy, he doesn't haullicinate but goes into a mode where he is pretending to be a mummy, dinosaur, etc and you can't get him to stop

Talking to himself in a way that might be mistaken for typical kids imagination but is more intense and constant

Delusions of grandure, he feels all powerful

Very argumentative, enraged if he thinks he is right and you question him

hair trigger, breaking or kicking things

The good news is, the sooner you can figure out the triggers and signs for your difficult child. The quicker you will be able to tweak medications and modify his environment to avoid going into a manic episode.

For my difficult child there are so many triggers. He has so many we are still learning them. For him we have noticed different times of the year are huge triggers. He just went through an almost two month period of much of the time being hypomanic. We were very close to hospitalization and finally tried one last thing at home that seems to be helping. For difficult child it almost always involves medication tweaking. This time we lowered one of his medications (per psychiatrist's directions) and that was a huge help.

Anxiety is a huge issue with us...but it's not typical anxiety. Missy has anxiety over upcoming events. She won't express that she's so excited, but it's definitely there. She doesn't express herself well. Perhaps if she did, the anxiety would be lessened; I dunno.

I don't tell Missy anything about upcoming events until the last possible minute. It's hard to do sometimes, but it has lessened the stress on her and doesn't give me the opportunity to tell her that I'm going to take the event away (as a punishment), therefore not punishing the whole family because she can't control herself.

Things like Christmas are problematic, because there is no way to keep that from her, but to ease some of the anxiety, we don't really decorate the house until several days before Christmas. I put a few things up, like outside lights and a few things around the house, but in the main room of the house, nothing goes up until the week before. The tree didn't go up until the Sunday before Christmas, this year.

In years past, I used to go all out the day after Thanksgiving and decorate the entire house, including the bathrooms. It's just way too much for her to handle, so the very first year that I had figured that out, we had much less mania to deal with.

Missy is super sensitive to food coloring and corn syrup. We had an episode just a few weeks ago, where husband caved and let her have a soda(corn syrup and food coloring) and a candy bar. husband didn't tell me this until two days later, after dealing with a mess the next morning. I had to bring her to school several hours after school began, because she was a mess. Then had to pick her up early for the same reason. It just reaffirms that she definitely has an issue with food coloring and corn syrup....especially to the family who all think I'm nuts for 'depriving' my poor child.